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    1. The document lists important developmental milestones in children, including copying a circle at age 3 and walking alone at 13-14 months. 2. It also covers parameters like body weight tripling by age 1 year, and body length increasing by 25 cm in a year. 3. The document provides information on common pediatric conditions like rickets, Down syndrome, and Turner syndrome, and their characteristic signs and symptoms. 4. It also outlines causes and features of conditions like jaundice, bronchiolitis, and anemias in children.

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    1. The document lists important developmental milestones in children, including copying a circle at age 3 and walking alone at 13-14 months. 2. It also covers parameters like body weight tripling by age 1 year, and body length increasing by 25 cm in a year. 3. The document provides information on common pediatric conditions like rickets, Down syndrome, and Turner syndrome, and their characteristic signs and symptoms. 4. It also outlines causes and features of conditions like jaundice, bronchiolitis, and anemias in children.

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    1. The document lists important developmental milestones in children, including copying a circle at age 3 and walking alone at 13-14 months. 2. It also covers parameters like body weight tripling by age 1 year, and body length increasing by 25 cm in a year. 3. The document provides information on common pediatric conditions like rickets, Down syndrome, and Turner syndrome, and their characteristic signs and symptoms. 4. It also outlines causes and features of conditions like jaundice, bronchiolitis, and anemias in children.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    43 views10 pages

    Pedia

    Uploaded by

    Kannan Kannan
    1. The document lists important developmental milestones in children, including copying a circle at age 3 and walking alone at 13-14 months. 2. It also covers parameters like body weight tripling by age 1 year, and body length increasing by 25 cm in a year. 3. The document provides information on common pediatric conditions like rickets, Down syndrome, and Turner syndrome, and their characteristic signs and symptoms. 4. It also outlines causes and features of conditions like jaundice, bronchiolitis, and anemias in children.

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    of 10

    -Dr.

    Singaram

    PAEDIATRICS

    IMPORTANT MILESTONES
     Copies circle: 3 years
     Crawls: 11 months
     Child smiles at familiar persons: 2 months
     Neck control: 3 month
     Sits with support: 6 months
     Transfer object from one hand to other: 6 months
     Says mama dada: 10 months
     Self decisions: 7 years
     Walks alone: 13-14 months
     Knows age & sex: 3 years
     Can draw a rectangle: 4 years
     Can draw a triangle: 5 years

    BODY PARAMETERS
     Body weight doubles at: 5 months
     Body weight triples at: 1 year
     Body length increases in year by: 25 cm

    NUTRITION
     Edema is seen in: Kwashiorkar
     Hepatomegaly is seen in: Kwashiorkar
     Acute malnutrition is judged by: Weight for height
     Chronic malnutrition is judged by: Height for age
     Flag sign is seen in: Kwashiorkar

    RICKETS
     Craniotabes (calvariae are softened),
     Rachitic rosary (prominent costochondral junction),
     Pot belly,
     Bow legs etc.
    -Dr. Singaram

     Biochemical values:
    o Low S. calcium & phosphate,
    o Raised alkaline phosphatase & PTH

    SCURVY
     Bleeding into skin & joints,
     Wimberger sign,
     Pseudoparalysis etc.

    DOWN SYNDROME
     MC trisomy,
     Brachycephalic skull,
     Hypotonia,
     Palpebral fissure slopes upwards,
     Marked epicanthic folds,
     Brushfield's spots,
     Increased nuchal fold thickness,
     Iliac index less than 60,
     Simian crease (single palmar crease),
     MC associated cardiac lesions: ASD/ Endocardial cushion defects
     Duodenal atresia, CML & transient myeloproliferative disorders are seen
     May be associated with Alzheimer's dementia,
     MC cause of down syndrome: Maternal non-disjunction

    TURNER SYNDROME
     Lymphedema,
     Short stature,
     Webbed neck,
     Low posterior hairline,
     Cubitus valgus (increased carrying angle),
     Finger deformities,
     Coarctation of aorta,
     Short 4th metacarpal,
     45 XO karyotype

    KLINEFELTER SYNDROME
    -Dr. Singaram

     47 XXY
     MC cause of hypergonadotrophic hypogonadism,
     Subnormal intelligence

    LATE CONGENITAL SYPHILIS


     Hutchinson's triad:
    o Hutchinson teeth,
    o 8th cranial nerve deafness &
    o Interstitial keratitis
     IgM FTA-ABS is best to diagnose congenital syphilis,
     Saddle nose, Sabre tibia &Clutton's joint

    JAUNDICE
     Causes of unconjugated hyperbilirubinemia:
    o CrigglerNajjar syndrome I & II,
    o Physiological jaundice,
    o Gilbert syndrome
    o Breast milk jaundice etc.
     Causes of conjugated hyperbilirubinemia: Biliary atresia (extrahepatic/ intrahepatic),
     MC cause of conjugated bilirubinemia in newborn: Idiopathic infantile hepatitis
     Physiological jaundice appears on: 3rd day (lasts upto 7th - 10th day in term & 14th day in
    preterm)
     MC cause of jaundice within 24 hours after birth: Erythroblastosisfetalis
     Breast milk jaundice is due to: Pregnandiole
     Kernicterus: Unconjugated bilirubin, in basal ganglia
     Rise in level of bilirubin in physiological jaundice: Less than 5 mg/ dl/ day

    INFANTILE HYPERTROPHIC PYLORIC STENOSIS


     Appears within 2-4 weeks after birth,
     Hypokalemic metabolic alkalosis,
     Compensated by:
    o Paradoxical aciduria,

    HYALINE MEMBRANE DISEASE


     Manifested within first few hours of life,
     Hyaline membrane is made of fibrin,
     Seen in:
    -Dr. Singaram

    o DM,
    o Premature babies
     Ground glass appearance/ reticulonodular/ reticulogranular pattern on chest radiography

    BRONCHIOLITIS
     MC Caused by Respiratory Synctial Virus/ RSV,
     MC in boys (less than 2 years),
     Chest X-ray shows:
    o Hyperinflation with
    o Multiple areas of interstitial infiltration
     May lead to asthma,
     Self limiting,
     DOC is ribavirin,
     Oxygen is helpful,
     RSV Immunoglobulins has no role in acute attacks,
     Antibiotics are not used initially

    ATRIAL SEPTAL DEFECT


     Left parasternal heave seen,
     Chest X-ray shows enlarged right atrium & ventricle (NOT Left atrium),
     Associated with Holt Oram syndrome
     ASD + Mitral stenosis: Lutembacher syndrome
     ASD + Single atrium: Ellis Crevald syndrome
     ASD + Bony abnormalities: Holt Oram syndrome
    VENTRICULAR SEPTAL DEFECT
     Left ventricular failure, Biventricular hypertrophy,
     Left axis deviation

    PATENT DUCTUS ARTERIOSUS


     Seen in rubella,
     Predisposed by:
    o Hypoxia &
    o Prematurity,
     Differential cyanosis is seen (cyanosis of toes but NOT of fingers)
     Prostaglandin inhibitor stimulate PDA closure

    COARCTATION OF AORTA
    -Dr. Singaram

     MC below origin of left subclavian artery,


     Associated with:
    o Turners syndrome,
    o Bicuspid aortic valve,
    o Upper extremity hypertension,

    o Lower extremity hypotension,


    o Headache,
    o Dizziness,
     Rib notching with double bulging is seen,
     Cause of death is:
    o Complications of hypertension,
    o Congestive heart failure etc.

    TETRALOGY OF FALLOT
     Components:
    o VSD,
    o Pulmonary stenosis,
    o Over-riding of aorta,
    o Right ventricular hypertrophy,
     Chest X-ray: Boot shaped heart/ couren sabot heart,
     Single S2,
     Ejection systolic murmur,
     Right sided aortic arch,
    Pentalogy of fallot
     TOF + ASD IRON
    DEFICIENCY ANEMIA/ IDA
     MC type of anemia in children: IDA
     Time to start iron supplementation to a term, breast fed baby: 6 weeks
     First indicator of response after iron therapy: Increased reticulocyte count

    ANEMIA
     Hypochromic, microcytic anemia with decreased serum iron & raised TIBC: Iron deficiency
    anemia
     Hypochromic, microcytic anemia with raised serum ferritin & decreased TIBC: Anemia of
    chronic diseases
     Early indicator of iron deficiency anemia: Serum ferritin

    THALASSEMIA
    -Dr. Singaram

     Features:
    o Splenomegaly,
    o Hemolyticfacies,
    o Decreased osmotic fragility (NOT increased),
    o Hair on end appearance (X-ray)
     Diagnostic test: Electrophoresis
     Microcytosis&hypochromia,
     Target & tear drop cells

    VON WILLEBRAND DISEASE


     Autosomal disease,
     MC hereditary bleeding disorder,
     APTT may be prolonged,
     BT prolonged,
     Factor VIII levels may be reduced
     Defective platelet aggregation with ristocetin

    THROMBOTIC THROMBOCYTOPENIC PURPURA/ TTP


     Pentad of TTP:
    o Fever,
    o Thrombocytopenia,
    o Microangiopathichemolyticanemia,
    o Neurological symptoms &
    o Renal failure
     Lab features:
    o BT prolonged,
    o Normal PT, PTT & complement

    VESICO-URETERAL REFLEX/ VUR


     MC cause of renal scarring in children,
     Presentation:
    o Straining & dribbling of urine
    o In a male child with
    o Recurrent UTI
     Diagnosis is by: MCUG/ micturatingcystourethrogram

    NEPHROTIC SYNDROME
    -Dr. Singaram

     MC of nephrotic syndrome in children: Minimal change disease (In adults, its Membranous
    GN)
     Characterized by:
    o Proteinuria (more than 3.5 gm/ day),
    o Hypoalbuminemia,
    o Edema,
    o Hyperlipidemia,
    o Lipiduria
    o Hypercoagulability,

    PAEDIATRIC ONCOLOGY
     MC inherited malignancy: Retinoblastoma
     MC malignant neoplasm in infancy: Neuroblastoma
     MC viral tumour: Warts
     MC malignant tumour (childhood): Leukemia

    NEUROBLASTOMA
     MC presentation: Large abdominal mass
     May present as:
     Lytic lesion in skull with
     Sutural diasthesis,
     MC mass in posterior mediastinum (children),
     Metastasizes to bone most commonly,
     Associated with hypertension &
     VMA &catecholamines are seen in urine

    WILM TUMOUR
     Also known as nephroblastoma,
     MC presenting symptom: Palpable abdominal mass
     Involves chromosome 11,
     Highest cure rates,
     Chemotherapy is with:
     Actinomycin-D &
     Vincristine

    GLYCOGEN STORAGE DISEASES


     Von gierkes disease is due to deficiency of: Glucose-6-phosphatase deficiency
    -Dr. Singaram

     Features of Von gierkes disease:


     Hyperuricemia,
     Lactic acidosis etc (NO muscles involvement)
     Andersen disease is due to deficiency of: Branching enzyme
     McArdles disease is due to deficiency of: Muscle phosphorylase
     Galactosemia:
     It is due to deficiency of GPUT/ galactose-1-phosphate-uridyl transferase; Reducing sugars
    are seen in

    PHENYLKETONURIA
     Deficiency of: Phenyl-Alanine Hydroxylase,
     Manifests as: Mental retardation, seizures etc.
     Urine: Musty odour
     Tests:
    o Ferric chloride,
    o Guthrie's test

    CONGENITAL HYPOTHYROIDISM
     Large & open posterior fontanelle,
     Absent social smile & eyebrows,
     Growth retardation,
     Delayed puberty,
     Cold extremities,
     Large tongue,
     Prolongation of physiological jaundice &
     Epiphyseal dysgenesis

    MENINGITIS
     MC presentation of neonatal meningitis: Poor breast feeding
     MC cause (in neonates) of bacterial meningitis: Group B streptococci/ E. coli
     Causes of aseptic meningitis:
    o Mumps virus,
    o Polio virus etc.
     Low CSF protein is seen in:
    o Infants,
    o Pseudotumourcerebri etc.

    NEONATAL SEIZURES
    -Dr. Singaram

     MC cause of seizure in newborn: Hypoxic ischemic encephalopathy


     MC type of seizure in newborn: Subtle (MC type of seizures in children: Generalized Tonic
    Clonic)
    DUCHENNE MUSCULAR DYSTROPHY
     Disease of sarcolemmal proteins (Dystrophin gene)
     Gowers sign (patient tries to climb on himself)
    Summary
    1. Child can copy a circle at the age of: 3 years
    2. Body weight of a child triples at: 1 year
    3. Flag sign (hair) is suggestive of: Kwashiorkar
    4. Rachitic rosary is a feature of: Rickets
    5. Mongolian facies is seen in: Down syndrome
    6. Karyotype in case of Turner syndrome: 45 XO
    7. Hutchinson triad is seen in: Late congenital syphilis
    8. MC cause of jaundice within 24 hours of life: Erythroblastosisfetalis
    9. Rise of bilirubin in physiological jaundice: Less than 5 mg/ dl/ day
    10. MC cause of bronchiolitis: Respiratory Synctial virus
    11. MC hear disorder in Down syndrome: ASD
    12. MC type of anemia in children: Iron deficiency anemia
    13. Hair on end appearance (radiograph) is seen in: Thalassemia
    14. Height of 100 cm is achieved by to age of: 4 years
    15. MC cause of nephrotic syndrome in children: Minimal change disease
    16. MC malignant neoplasm in infancy: Neuroblastoma
    17. MC presentation of neuroblastoma: Abdominal mass
    18. MC cause of meningitis in neonates: E. coli/ Group B streptococcus
    19. Enzyme deficient in Von-Gierke's disease: G-6-phosphatase
    20. Urine in phenylketonuria: Mousy/ musty odour
    21. Urine turns/ dark on exposure to atmosphere in: Alkaptonuria
    22. MC type of seizure in newborn: Subtle
    23. MC type of seizure in childhood: Generalized tonic clonic
    24. Most of the babies are bed-dry at the gae of: 5 years
    25. Condition in which unconjugated bilirubin gets deposited in basal ganglia: Kernicterus
    Few suggestions:
    On milestones:
    Child smiles at human faces (social smile) : 2 months
    Walk alone : 15 months
    Draws Cross/plus : 4 years
    Body length increases in 1st year by 25 cm.
    Pyloric stenosis: Appears by 2 - 4 weeks
    PDA with Eisenmenger syndrome - Differential cyanosis is seen.
    Iron supplementation is not required for term babies.
    (Only for preterms)
    von Willwbrand - Autosomal dominant usually
    MC cause nephrotic in adults is FSGS
    Proteinuria in children is >40mg/m2/day
    -Dr. Singaram

    Most common cause of neonatal meningitis : E.coli


    Most common cause of aseptic/viral meningitis - JE virus

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